This is a legal form that was released by the Alabama Medicaid Agency - a government authority operating within Alabama. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form 506?
A: Form 506 is a report used to notify Alabama Medicaid of insurance coverage changes.
Q: Who needs to file Form 506?
A: Anyone who has Medicaid coverage in Alabama and experiences changes in their insurance coverage needs to file Form 506.
Q: What changes in insurance coverage should be reported on Form 506?
A: Changes such as the start or end of insurance coverage, changes in insurance policies, or changes in insurance providers should be reported on Form 506.
Q: What information is required on Form 506?
A: Form 506 requires information such as the individual's name, Medicaid ID number, insurance policy details, and dates of coverage changes.
Form Details:
Download a fillable version of Form 506 by clicking the link below or browse more documents and templates provided by the Alabama Medicaid Agency.